By Mukti Shah
Watching Gabor Mate’s ‘The Wisdom of Trauma’ reminded me of the time I worked briefly in a Drug Rehab programme (over 14 years ago) and it followed the then unusual but now popular, Drug Harm Reduction approach. This approach is pragmatic and acknowledges the often-impossible struggles people have in managing their addictions (never cured, always in recovery).
This particular project was housed in a large shed, with an asbestos roof, in a slum in a suburb on the outskirts of Pune. The deal was simple. If you entered the programme, you received one hot meal, access to a doctor, a psychologist, a substitute drug that reduced dependence, fresh disposable needles and possibly, recovery. My clients were largely the homeless, women who offered sex in exchange of a substance, beggar-folk or petty thieves or pickpockets who would jump on to the trains going up and down the Mumbai-Pune line (I had my purse ‘almost’ stolen twice!).
I was young, and had enough of addiction in my own family system and not enough of personal work or supervision (that concept didn't really exist for MH training in India then!) to continue working untriggered and retraumatised there. This is also why I never pursued working in de-addiction. I learned a lot however. One such concept is that of, ‘Euphoric Recall’. This is a state when the person has stopped using the substance but spends their time fixated on the positive outcomes of the addiction, the high, the pleasure or euphoria experienced, the sense of connection with everything, and increased confidence, etc.
All good stuff except they are all temporary and the negative consequences of their addiction are masked under the euphoric recall. Sobering up is painful because it leads to a sense of numbness and depression and this is amplified in comparison with the prolonged serotonin and dopamine high that addicts are used to. They block or repress the associated reality of the damage caused to their health, the trauma and exploitation they have undergone and the relationships that have been destroyed in pursuit of the substance.This is the mechanism of relapse which if unbroken can keep the user from ever fully sobering up.
“You know, it’s funny, when you look at someone through rose-coloured glasses, all the red flags just look like flags.” - Wanda the Owl, BoJack Horseman (Season 2, Episode 10)
Nowadays I notice this everywhere. For example, when I hear clients freshly out of abusive relationships start talking about the initial great days, the amazing make-up sex, the erratic grand gestures designed to reel them in, I know it is the Euphoric Recall doing mischief! The client wants their ‘fix’ of post break-up love-bombing. This is the time to remind them about all the times they were mistreated. It is time to remind them of the controlling, manipulation, lying and isolation, to revisit all the greatest hits of abusive texts or e-mails you made them save for this very eventuality, to dig out the pictures of empty, terrified forced smiles in couple pictures. This dysphoric recall technique works many times, but it fails often too unfortunately. So, they 'relapse' by going back into the abusive relationship and eventually return to therapy swearing never to go back and begin all over again.
In a non-addiction context, the dysphoric recall is a great technique to help with procrastination, cultivating healthy habits and building the delayed gratification muscle. As I write this, I realise that in a way, I guess I do deal with addiction in my practice now! This addiction is not of substances but of relationships, success, shopping, doom-scrolling, dependence, avoidant behaviour, work, tech, even being right. Anything that we overuse to distract from the reality of our emotional pain has the potential of becoming an addiction. As Jung put it in his book titled Memories, Dreams and Reflections (chapter 12), “every form of addiction is bad, no matter whether the narcotic be alcohol or morphine or idealism”.
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